I 

114TH CONGRESS 

1ST SESSION H. R. 3974 

To require the Secretary of Veterans Affairs to carry out a pilot program 

to provide educational assistance to certain former members of the Armed 

Forces for education and training as physician assistants of the Department of Veterans Affairs, to establish pay grades and require competitive 

pay for physician assistants of the Department, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 5, 2015 

Ms. KUSTER (for herself and Mr. HECK of Nevada) introduced the following 

bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To require the Secretary of Veterans Affairs to carry out 

a pilot program to provide educational assistance to certain former members of the Armed Forces for education 

and training as physician assistants of the Department 

of Veterans Affairs, to establish pay grades and require 

competitive pay for physician assistants of the Department, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Grow Our Own Direc3 tive: Physician Assistant Employment and Education Act 

4 of 2015’’. 

5 SEC. 2. PILOT PROGRAM TO PROVIDE EDUCATIONAL AS6 SISTANCE TO PHYSICIAN ASSISTANTS TO BE 

7 EMPLOYED AT THE DEPARTMENT OF VET8 ERANS AFFAIRS. 

9 (a) PILOT PROGRAM.— 

10 (1) IN GENERAL.—The Secretary of Veterans 

11 Affairs shall carry out a pilot program to be known 

12 as the ‘‘Grow Our Own Directive’’ or ‘‘G.O.O.D.’’ 

13 pilot program (in this section referred to as the 

14 ‘‘pilot program’’) to provide educational assistance 

15 to certain former members of the Armed Forces for 

16 education and training as physician assistants of the 

17 Department of Veterans Affairs. 

18 (2) INFORMATION ON PILOT PROGRAM.—The 

19 Secretary shall provide information on the pilot pro20 gram to eligible individuals under subsection (b), in21 cluding information on application requirements and 

22 a list of entities with which the Secretary has 

23 partnered under subsection (g). 

24 (b) ELIGIBLE INDIVIDUALS.—An individual is eligi25 ble to participate in the pilot program if the individual— 


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1 (1) has medical or military health experience 

2 gained while serving as a member of the Armed 

3 Forces; 

4 (2) has received a certificate, associate degree, 

5 baccalaureate degree, master’s degree, or 

6 postbaccalaureate training in a science relating to 

7 health care; 

8 (3) has participated in the delivery of health 

9 care services or related medical services, including 

10 participation in military training relating to the 

11 identification, evaluation, treatment, and prevention 

12 of diseases and disorders; and 

13 (4) does not have a degree of doctor of medi14 cine, doctor of osteopathy, or doctor of dentistry. 

15 (c) DURATION.—The pilot program shall be carried 

16 out during the five-year period beginning on the date that 

17 is 180 days after the date of the enactment of this Act. 

18 (d) SELECTION.— 

19 (1) IN GENERAL.—The Secretary shall select 

20 not less than 250 eligible individuals under sub21 section (b) to participate in the pilot program. 

22 (2) PRIORITY FOR SELECTION.—In selecting in23 dividuals to participate in the pilot program under 

24 paragraph (1), the Secretary shall give priority to 

25 the following individuals: 


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1 (A) Individuals who participated in the In2 termediate Care Technician Pilot Program of 

3 the Department that was carried out by the 

4 Secretary between January 2011 and February 

5 2015. 

6 (B) Individuals who agree to be employed 

7 as a physician assistant for the Veterans Health 

8 Administration at a medical facility of the De9 partment located in a community that— 

10 (i) is designated as a medically under11 served population under section 

12 330(b)(3)(A) of the Public Health Service 

13 Act (42 U.S.C. 254b(b)(3)(A)); and 

14 (ii) is in a State with a per capita 

15 population of veterans of more than 9 per16 cent according to the National Center for 

17 Veterans Analysis and Statistics and the 

18 United States Census Bureau. 

19 (e) EDUCATIONAL ASSISTANCE.— 

20 (1) IN GENERAL.—In carrying out the pilot 

21 program, the Secretary shall provide educational as22 sistance to individuals participating in the pilot pro23 gram, including through the use of scholarships, to 

24 cover the costs to such individuals of obtaining a 


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1 master’s degree in physician assistant studies or a 

2 similar master’s degree. 

3 (2) USE OF EXISTING PROGRAMS.—In pro4 viding educational assistance under paragraph (1), 

5 the Secretary shall use the Department of Veterans 

6 Affairs Health Professionals Educational Assistance 

7 Program under chapter 76 of title 38, United States 

8 Code, and such other educational assistance pro9 grams of the Department as the Secretary considers 

10 appropriate. 

11 (3) USE OF SCHOLARSHIPS.—The Secretary 

12 shall provide not less than 35 scholarships under the 

13 pilot program to individuals participating in the pilot 

14 program during each year in which the pilot pro15 gram is carried out. 

16 (f) PERIOD OF OBLIGATED SERVICE.— 

17 (1) IN GENERAL.—The Secretary shall enter 

18 into an agreement with each individual participating 

19 in the pilot program in which such individual agrees 

20 to be employed as a physician assistant for the Vet21 erans Health Administration for a period of obli22 gated service specified in paragraph (2). 

23 (2) PERIOD SPECIFIED.—With respect to each 

24 individual participating in the pilot program, the peVerDate Sep 11 2014 01:13 Nov 10, 2015 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3974.IH H3974

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1 riod of obligated service specified in this paragraph 

2 for the individual is— 

3 (A) if the individual is participating in the 

4 pilot program through a program described in 

5 subsection (e)(2) that specifies a period of obli6 gated service, the period specified with respect 

7 to such program; or 

8 (B) if the individual is participating in the 

9 pilot program other than through a program 

10 described in such subsection, or if such program 

11 does not specify a period of obligated service, a 

12 period of three years or such other period as 

13 the Secretary considers appropriate for pur14 poses of the pilot program. 

15 (g) BREACH.— 

16 (1) LIABILITY.—Except as provided in para17 graph (2), an individual who participates in the pilot 

18 program and fails to satisfy the period of obligated 

19 service under subsection (f) shall be liable to the 

20 United States, in lieu of such obligated service, for 

21 the amount that has been paid or is payable to or 

22 on behalf of the individual under the pilot program, 

23 reduced by the proportion that the number of days 

24 served for completion of the period of obligated servVerDate Sep 11 2014 01:13 Nov 10, 2015 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3974.IH H3974

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1 ice bears to the total number of days in the period 

2 of obligated service of such individual. 

3 (2) EXCEPTION.—If an individual is partici4 pating in the pilot program through a program de5 scribed in subsection (e)(2) that specifies a period of 

6 obligated service, the liability of the individual for 

7 failing to satisfy the period of obligated service 

8 under subsection (f) shall be determined as specified 

9 with respect to such program. 

10 (h) MENTORS.—The Secretary shall ensure that a 

11 physician assistant mentor or mentors are available for in12 dividuals participating in the pilot program at each facility 

13 of the Veterans Health Administration at which a partici14 pant in the pilot program is employed. 

15 (i) PARTNERSHIPS.—In carrying out the pilot pro16 gram, the Secretary shall seek to partner with the fol17 lowing: 

18 (1) Not less than 15 institutions of higher edu19 cation that— 

20 (A) offer a master’s degree program in 

21 physician assistant studies or a similar area of 

22 study that is accredited by the Accreditation 

23 Review Commission on Education for the Phy24 sician Assistant; and 

25 (B) agree— 


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1 (i) to guarantee seats in such master’s 

2 degree program for individuals partici3 pating in the pilot program who meet the 

4 entrance requirements for such master’s 

5 degree program; and 

6 (ii) to provide individuals partici7 pating in the pilot program with informa8 tion on admissions criteria and the admis9 sions process. 

10 (2) Other institutions of higher education that 

11 offer programs in physician assistant studies or 

12 other similar areas of studies that are accredited by 

13 the Accreditation Review Commission on Education 

14 for the Physician Assistant. 

15 (3) The Transition Assistance Program of the 

16 Department of Defense. 

17 (4) The Veterans’ Employment and Training 

18 Service of the Department of Labor. 

19 (5) Programs carried out under chapter 41 of 

20 title 38, United States Code, for the purpose of mar21 keting and advertising the pilot program to veterans 

22 and members of the Armed Forces who may be in23 terested in the pilot program. 

24 (j) ADMINISTRATION OF PILOT PROGRAM.—For pur25 poses of carrying out the pilot program, the Secretary 


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1 shall appoint or select within the Office of Physician As2 sistant Services of the Veterans Health Administration the 

3 following: 

4 (1) A Deputy Director for Education and Ca5 reer Development of Physician Assistants who— 

6 (A) is a physician assistant, a veteran, and 

7 employed by the Department as of the date of 

8 the enactment of this Act; 

9 (B) is responsible for— 

10 (i) overseeing the pilot program; 

11 (ii) recruiting candidates to partici12 pate in the pilot program; 

13 (iii) coordinating with individuals par14 ticipating in the pilot program and assist15 ing those individuals in applying and being 

16 admitted to a master’s degree program 

17 under the pilot program; and 

18 (iv) providing information to eligible 

19 individuals under subsection (b) with re20 spect to the pilot program; and 

21 (C) may be employed in the field at a med22 ical center of the Department. 

23 (2) A Deputy Director of Recruitment and Re24 tention who— 


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1 (A) is a physician assistant, a veteran, and 

2 employed by the Department as of the date of 

3 the enactment of this Act; 

4 (B) is responsible for— 

5 (i) identifying and coordinating the 

6 needs of the pilot program and assist the 

7 Secretary in providing mentors under sub8 section (h) to participants in the pilot pro9 gram; and 

10 (ii) coordinating the staff of facilities 

11 of the Veterans Health Administration 

12 with respect to identifying employment po13 sitions and mentors under subsection (h) 

14 for participants in the pilot program; and 

15 (C) may be employed in the field at a med16 ical center of the Department. 

17 (3) A recruiter who— 

18 (A) reports directly to the Deputy Director 

19 of Recruitment and Retention; and 

20 (B) works with the Workforce Manage21 ment and Consulting Office and the Healthcare 

22 Talent Management Office of the Veterans 

23 Health Administration to develop and imple24 ment national recruiting strategic plans for the 


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1 recruitment and retention of physician assist2 ants within the Department. 

3 (4) An administrative assistant, compensated at 

4 a rate not less than level GS–6 of the General 

5 Schedule, or equivalent, who assists with administra6 tive duties relating to the pilot program in the Office 

7 of Physician Assistant Services and such other du8 ties as determined by the Secretary to ensure that 

9 the Office runs effectively and efficiently. 

10 (k) REPORT.— 

11 (1) IN GENERAL.—Not later than one year 

12 after the date of the enactment of this Act, the Sec13 retary of Veterans Affairs, in collaboration with the 

14 Secretary of Labor, the Secretary of Defense, and 

15 the Secretary of Health and Human Services, shall 

16 submit to Congress a report on the pilot program. 

17 (2) ELEMENTS.—The report required by para18 graph (1) shall include the following: 

19 (A) The extent to which the pilot program 

20 is effective in improving the ability of eligible 

21 individuals under subsection (b) to become phy22 sician assistants; 

23 (B) An examination of whether the pilot 

24 program is achieving the goals of— 


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1 (i) enabling individuals to build on 

2 medical skills gained as members of the 

3 Armed Forces by entering into the physi4 cian assistant workforce of the Depart5 ment; and 

6 (ii) helping to meet the shortage of 

7 physician assistants employed by the De8 partment. 

9 (C) An identification of such modifications 

10 to the pilot program as the Secretary of Vet11 erans Affairs, the Secretary of Labor, the Sec12 retary of Defense, and the Secretary of Health 

13 and Human Services consider necessary to meet 

14 the goals described in subparagraph (B). 

15 (D) An assessment of whether the pilot 

16 program could serve as a model for other pro17 grams of the Department to assist individuals 

18 in obtaining certification and employment in 

19 other health care fields. 

20 (l) SOURCE OF AMOUNTS.—Not less than $8,000,000 

21 of the amount necessary to carry out the pilot program 

22 shall be derived from amounts appropriated to the Depart23 ment of Veterans Affairs before the date of the enactment 

24 of this Act. 


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1 SEC. 3. ESTABLISHMENT OF STANDARDS FOR THE DEPART2 MENT OF VETERANS AFFAIRS FOR USING 

3 EDUCATIONAL ASSISTANCE PROGRAMS TO 

4 EDUCATE AND HIRE PHYSICIAN ASSISTANTS. 

5 (a) IN GENERAL.—The Secretary of Veterans Affairs 

6 shall establish standards described in subsection (b) to im7 prove the use by the Department of Veterans Affairs of 

8 the Department of Veterans Affairs Health Professionals 

9 Educational Assistance Program under chapter 76 of title 

10 38, United States Code, and other educational assistance 

11 programs of the Department, including the pilot program 

12 under section 2, to educate and hire physician assistants 

13 of the Department. 

14 (b) STANDARDS.—The standards described in this 

15 subsection are the following: 

16 (1) Holding directors of medical centers of the 

17 Department accountable for failure to use the edu18 cational assistance programs described in subsection 

19 (a) and other incentives— 

20 (A) to advance employees of the Depart21 ment in their education as physician assistants; 

22 and 

23 (B) to improve recruitment and retention 

24 of physician assistants. 

25 (2) Ensuring that the Department of Veterans 

26 Affairs Education Debt Reduction Program under 


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1 subchapter VII of chapter 76 of such title is avail2 able for participants in the pilot program under sec3 tion 2 to fill vacant physician assistant positions at 

4 the Department, including by— 

5 (A) including in all vacancy announce6 ments for physician assistant positions the 

7 availability of the Education Debt Reduction 

8 Program; and 

9 (B) informing applicants to physician as10 sistant positions of their eligibility for the Edu11 cation Debt Reduction Program. 

12 (3) Monitoring compliance with the application 

13 process for educational assistance programs de14 scribed in subsection (a) to ensure that such pro15 grams are being fully utilized to carry out this sec16 tion. 

17 (4) Creating programs, including through the 

18 use of the Department of Veterans Affairs Employee 

19 Incentive Scholarship Program under subchapter VI 

20 of chapter 76 of such title, to encourage employees 

21 of the Department to apply to accredited physician 

22 assistant programs. 

23 (c) REGULATIONS.—The Secretary shall prescribe 

24 such regulations as the Secretary considers appropriate to 

25 carry out this section. 


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1 SEC. 4. ESTABLISHMENT OF PAY GRADES FOR PHYSICIAN 

2 ASSISTANTS OF THE DEPARTMENT OF VET3 ERANS AFFAIRS AND REQUIREMENT TO PRO4 VIDE COMPETITIVE PAY. 

5 (a) ESTABLISHMENT OF PAY GRADES.—Section 

6 7404(b) of title 38, United States Code, is amended by 

7 adding at the end the following: 

‘‘PHYSICIAN ASSISTANT SCHEDULE 

‘‘Physician Assistant IV. 

‘‘Physician Assistant III. 

‘‘Physician Assistant II. 

‘‘Physician Assistant I.’’. 

8 (b) COMPETITIVE PAY.—Section 7451(a)(2) of such 

9 title is amended— 

10 (1) by redesignating subparagraph (B) as sub11 paragraph (C); 

12 (2) by inserting after subparagraph (A) the fol13 lowing new subparagraph (B): 

14 ‘‘(B) Physician assistant.’’; and 

15 (3) in subparagraph (C), as redesignated by 

16 paragraph (1), by striking ‘‘and registered nurse’’ 

17 and inserting ‘‘registered nurse, and physician as18 sistant’’. 

19 (c) NATIONAL STRATEGIC PLAN.— 

20 (1) IN GENERAL.—The Secretary of Veterans 

21 Affairs shall implement a national strategic plan for 

22 the retention and recruitment of physician assistants 

23 of the Department of Veterans Affairs that includes 


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1 the establishment and adoption of standards for the 

2 provision of competitive pay to physician assistants 

3 of the Department in comparison to the pay of phy4 sician assistants in the private sector. 

5 (2) REPORT.—Not later than one year after the 

6 date of the enactment of this Act, the Secretary 

7 shall submit to the Committee on Veterans’ Affairs 

8 of the Senate and the Committee on Veterans’ Af9 fairs of the House of Representatives a report on the 

10 implementation of the national strategic plan under 

11 paragraph (1). 

Æ 


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